Effectiveness of screening for tuberculosis in HIV
A pragmatic clinical trial
Bibliographic Data
| ID | 16780540 |
|---|---|
| Authors | Marcela Lopes Santos (0000-0002-1283-7962, Instituto de Saúde), Joanna D’arc Lyra Batista (0000-0002-3703-2845, Universidade Federal da Fronteira Sul), Maria Cynthia Braga (0000-0002-7862-6455, Instituto de Saúde), Adriana Paula Da Silva (0000-0002-2803-6326, Hospital do Coração), Magda Maruza (0000-0002-3326-8885, Hospital do Coração), Wayner Vieira De Souza (0000-0002-0939-9332, Instituto de Saúde), Maria Rosimery De Carvalho (0000-0002-9588-1204, Instituto de Saúde), Noemia Teixeira de Siqueira-Filha (0000-0003-0730-8561, University of York), Maria De Fátima Pessoa Militão De Albuquerque (0000-0002-4999-4160, Instituto de Saúde) |
| Year | 2021 |
| Volume | 55 |
| Pages | 45 |
| Publication date | 2021-07-23 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Revista de Saúde Pública (JOURNAL) |
| Journal identifiers | ISSN: 0034-8910 • E-ISSN: 0034-8910 |
| Publisher | Universidade de São Paulo. Agência de Bibliotecas e Coleções Digitais (PUBLISHER) |
| DOI | 10.11606/s1518-8787.2021055002936 |
| OpenAlex | W3183299291 |
| Language | EN |
| References cited | 3 |
OBJECTIVE: To verify the effectiveness of screening for tuberculosis (TB) on all-cause mortality and tuberculosis cases in newly diagnosed HIV-infected patients through a clinical algorithm based on recommendations of the World Health Organization. METHODS: From March 2014 to April 2016, a pragmatic randomized clinical trial was conducted with newly diagnosed and TB-free HIV-infected adults undergoing antiretroviral therapy for up to one month at a major tertiary hospital for HIV in the state of Pernambuco, Brazil. Participants were randomized into intervention and control groups using an automatically-generated random list, and followed-up for at least 6 months. The intervention group was screened for TB at hospital admission and at every follow-up visit through a series of questions addressing TB-related symptoms (cough, fever, night sweating, and weight loss). Patients presenting with any of these symptoms were referred to a pulmonologist and underwent sputum smear microscopy, sputum culture, and rapid molecular testing (GeneXpert). When at least one test result came back positive, TB treatment was initiated. In turn, if patients tested negative but presented with severe clinal symptoms, TB preventive treatment was initiated. Screening for TB was not performed systematically in the control group. The primary outcome assessed in this study was death from all causes, and secondary outcomes included sensitivity and specificity of this screening test, as well as its detection time. RESULTS: This study evaluated 581 patients, 377 in the intervention group (64.9%) and 204 in the control group (35.1%). In total, 36 patients died during the follow-up period. Of these, 26 (6.9%) were from the intervention group, reaching a cumulative mortality coefficient of 69 per 1,000 inhabitants, and 10 (4.9%) from the control group (p = 0.341), with a cumulative mortality coefficient of 49 per 1,000 inhabitants (p = 0.341)
Clinical trial · GeneXpert MTB/RIF · Intervention (counseling) · Pathology · Randomized controlled trial · Sputum · Sputum culture · Tuberculosis · HIV/AIDS Research and Interventions · Internal Medicine · Medicine · Pneumocystis jirovecii pneumonia detection and treatment · Tuberculosis Research and Epidemiology · Pediatrics
| Highly cited | No |
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